Molecular epidemiology of respiratory syncytial virus

Abstract

Human respiratory syncytial virus (RSV) is the major cause of lower respiratory tract disease in infants. It is unusual in that it causes repeated infections throughout life. Despite considerable efforts there is as yet no satisfactory vaccine available. This paper reviews the molecular epidemiology of the RSV and describes the complex genotypic structure of RSV epidemics. The evolution of the virus is discussed, with particular reference to the antigenic and genetic variability of the attachment glycoprotein.

The transmission dynamics of groups A and B human respiratory syncytial virus (hRSV) in England & Wales and Finland: seasonality and cross-protection

“…The virus exhibits considerable genetic variability, primarily in the attachment (G) glycoprotein [2]. This variability is reflected antigenically, and hRSV can be divided into two groups (A and B) on the basis of reactions with panels of monoclonal antibodies [3,4].…”

“…older children have larger airways [12]. Clearly immunity is not necessarily protective against re-infection, but it is unclear to what extent immunity to disease or re-infection is group specific [2,13].…”

“…In the United Kingdom, the annual epidemic peaks between late December and early January, and a cyclic, triennial pattern in genetic variation in groups A and B has been observed in Birmingham, UK [2,14]. The transmission of hRSV in Turku, Finland has followed a distinctive quadrennial pattern for the past 20 years [15] : every 2 years there is a minor peak in April followed by a major peak in December.…”

“…The characteristic recurrent epidemics of hRSV are, on the whole, observed through hospital surveillance, with cases consisting predominantly of young children experiencing severe disease from their primary infection [2]. Epidemics have been recorded in community and family study settings, and the link between elder school siblings and primary infant cases is strong [6,16,17].…”

Localized contacts between hosts reduce pathogen diversity

“…Epidemics of acute respiratory infection occuring each winter in temperate climates are caused in general by influenza (Hay 2001) and respiratory syncytial viruses (Cane 2001). Rotaviruses (Iturriza-Gómara 2004) are the single most common cause of acute infantile gastroenteritis throughout the world.…”